Reconstruction of the Nasal Soft Triangle: A Systematic Review.

Abstract

The nasal subunit of the soft triangle is an area known for its unique reconstructive challenges due to its complex anatomical structure coupled with its critical aesthetic and functional roles. The systematic review was performed using PRISMA guidelines to evaluate techniques for soft triangle reconstruction and help guide surgeons for their best-fit reconstruction based on the size and composition of the defect they are faced with. A literature search was conducted to include the databases of MEDLINE via OVID, EMBASE, CINAHL, PubMed, and Cochrane central registry of trials. In the review, 13 studies were selected, encompassing 900 patients with differing defects ranging from 0.6 to 5.5 cm in size. Our study outlines complication rates experienced, revision rate, and surgeon vs patient outcome measures where they are reported. We have found that while composite grafts are effective for smaller defects, they experience a high number of complication rates, and therefore, for larger defects, we recommend using vascularized interpolated flaps with cartilage support grafts. This review underscores the importance of tailored approaches, anatomical understanding, and patient-centered decision-making. Future research should prioritize comparative studies and standardized evaluation metrics to enhance evidence-based guidelines.